10 Reasons You Are Not Cut Out To Be A 1099 CRNA

We are going to deviate from the general theme today to discuss something that I have wanted to write about for a long time. The perks of the 1099 CRNA life are obvious to many (such as the increased pay, the flexibility of hours, the tax benefits, etc.) and the challenges are a dime a dozen (loss of benefits, self filing tax, corporations, etc.), however, the intrinsic reasons why you as an individual might not be cut out for it are not always the most obvious.

Here’s a list I have come up with that can hopefully help aspiring and current 1099 CRNAs.

You Require Easy Assignments

There is a certain type of CRNA who is always in the breakroom at breakfast or lunch (and sometimes even before the shift starts), moaning and groaning about the assignment they got. “I can’t believe they put me in Cath Lab”, “Gosh I am in OB, againnnn!!”, “I hate working with doctor so and so, I can’t believe I am in his room today”, “Why don’t I ever get the easy cases like so and so”. If any of that sounds like you, then maybe you may want to reconsider being a 1099 CRNA.

Most of the time, the concept of working 1099 means that certain facilities are short staffed and you are getting premium pay to go out there and help. That in and of itself implies inconvenience. If the hospital/facility was a dream place to work then they would not need your help. Instead, they would be full to the brim with W2 people clamoring for the opportunity to work there. As a 1099 CRNA, you are going to go places with limited resources, inept staff, inadequate hospital procedures, inefficient scheduling, possibly rude and demanding surgeons, amongst other things. The expectation is you roll up your sleeves and take the punches while thinking of your paycheck. If you cannot do that, then maybe reconsider.

You Are Limited to the Type of Cases You Can Do

“I don’t do peds… I don’t do CV…. I don’t do OB… Can’t do cases with fluoro because I am pregnant… oh cases with cement are out too… I don’t do trauma… Can’t do blocks… Not interested in spinals… Can’t do ASA 3 or 4”. Does this sound like you? It is actually quite alright to be one or two of these but at the point you find yourself saying three or more of these then maybe 1099 is not for you.

As already stated, you are getting paid top dollar to come in and hit the ground running. Maybe you can’t do blocks, but are you open to learning? Sure you don’t do CV, that’s specialized but can you do a carotid endarterectomy? Okay, you are pregnant, but when they send you to endo you can’t spend the day b****ing and moaning about it. If you can’t do that, then you might want to sit back in your comfy W2 job because 1099 may not be for you.

You Are Not A People Person

What does being a people person have to do with possibly the most isolating job in healthcare? Good question. Being 1099 means you are not one of them. It means you are here to help and once things are steady you may have to be on your way. But, you also need a job. You need places to go to work so that you can afford to pay your bills.

As a 1099 CRNA, you start to realize the role “likeability” plays in your career, possibly for the first time. Even when places no longer need 1099 folks, they may still reach out to those they consider “friends” or “nice to work with” in times when they have a need. That means, the people persons will be able to stay on at the nicer gigs for longer simply because people like them. If you are generally unliked, you might find yourself getting asked not to return to certain sites or being kindly told “we are not taking 1099 people after this month”, yet others are not told the same. So if you are generally an abrasive person or one who lives and works in solitude then you might have to reconsider this role.

You Are Inflexible

This point kind of plays off the last point and relates to people politics. In order to get into these good graces, sometimes you have to do things that are slightly inconvenient for you in order to help the “team”. This is how you get remembered and this is how you enter good books.

It means picking up on Wednesday instead of Tuesday in order to help rebalance the schedule. It means taking a half day on your day off so you can help with their short-staffed day. You see most of these examples don’t necessarily involve putting yourself out. However, the slight inconvenience on your part shows them that you care about them and in turn they feel the urge to care about you too. You honestly do not have to do these. However, being able to do this might make your 1099 transition smoother.

You Leave A Trail of Enemies Everywhere You Go

When you go in to give your colleague a breakfast break, are you the type to change up all their vent settings? And then when they return you proceed to give them a lecture about why your way is better? Essentially implying they are an inept provider? That is a sure fire way to make enemies.

Are you the type to relieve the 8-hr CRNAs at exactly 2:59:59pm every single time? That’s a definite way to make enemies.

You honestly don’t need to be everybody’s friend, but in the 1099 world, information is power and nobody gives information to someone they dislike. Why? Because if I know of a better paying gig, I would hate to see my enemy there too.

You Are An Unsafe Anesthetist

The point makes itself. Anesthesia is a small world. If you have developed a reputation for requiring narcan in PACU on 80% of your cases, or 50% of your patient having an undesirable outcome, that goes around. Facilities are going to be hesitant to onboard someone who is going to come in and kill their patients.

You Do Not Know How to Ask For Help

In as much as it is important to be skilled as an anesthetist, it is also important to know when to ask for help. If your ego is too huge to identify that you need a second hand in emergencies, then that is a personality type that is difficult to maintain in the 1099 world. Your colleagues, your chiefs, your surgeons, your teams, they all need to confident that not only is the patient safe with you. That you are also safe enough to ask for help, or to ask questions when you don’t know things.

You should be able to say, “hey I haven’t done one of these procedures in a while, what are somethings I should know.” “Hey, this EKG strip is looking funky to me, but I am not too sure, can you pop your head into my OR and take a look.” “Hey, is this drug safe for this sort of patient.” “Hey, how do you do your T&A’s on peds cases?” etc. It doesn’t make you any less impressive a CRNA, it makes your patients safe. And when people know that you will ask when you are unsure, they trust you more.

You Are Shy to Speak Up

Are you the type who can’t ask for what you want? You need to make schedule changes but you are paralyzed by fear. You need to request accomodations with your case types uut because you don’t know these people quite as well, you are hesitant to speak up?

Life happens, even in 1099 and just because you are a business now does not mean that you have to endure things without having a conversation first. I work with 1099 folks who start each day at 0900 or leave at 1600 and that’s because that is what they need for their life schedule. However, they would never have that schedule if they do not speak up. If you are unable to ask for what you want then maybe reconsider 1099 because the lifestyle requires you to be comfortable with discomfort.

You Are Frightened of Change

There are certain people who need consistency in their life for peace. They do not function well when they have to constantly change their work environment or work colleagues. For people like this, the 1099 life will be challenging. This is because it requires constant change and it requires you to be able to preempt the change. If you are too paralyzed by the thought of the change to constantly stay ahead of it, then the comforts of a W2 might just be for you.

You Don’t Know How To Play The Game

So, what’s the game? The game is multilayered and deserves its own post. However, the game is a combination of people politics, staying credentialed at multiple places, maintaining those credentials, staying in close contact with the people who can give you jobs and keeping your ear to the ground on what your particular anesthesia market is doing. It requires you to know what is important to you and stay prepped to adapt to constant change. The game requires a base degree of stress, and if stress is not for you, then maybe 1099 is not for you.